title: Long-term compliance with salt restriction assessed using the spot urine method in Japanese cardiology outpatients.
abstract: The purpose of this study was to evaluate long-term compliance with salt restriction in Japanese cardiology outpatients assessed by spot urine measurements. A total of 466 patients (72 ± 10 years old, 216 females) who visited a cardiology outpatient clinic and were followed for at least 1 year were included in this study. Daily dietary salt intake was estimated based on the sodium and creatinine concentrations determined by spot urine at the time of enrollment, during an 8-26 week follow-up and at a long-term follow-up (>1 year). The average follow-up duration was 2.2 ± 0.6 (1.0-3.4) years after enrollment, and spot urines were collected 5.2 ± 2.8 times after 1 year. The baseline estimated salt excretion was 9.6 ± 2.7 g per day, which was reduced to 8.7 ± 2.3 g per day (P<0.01) at 8-26 weeks and remained unchanged at the long-term follow-up (8.9 ± 2.0 g per day, P = 0.36 vs. 8-26 weeks, P < 0.01 vs. baseline). The percent of patients who achieved an average salt excretion<6.0 g per day was unchanged from baseline (6.9% vs. 7.7%, P = 0.61). Among several variables (gender, age, body weight, salt excretion at enrollment) that might affect the incidence of salt excretion <6.0 g per day, salt excretion at baseline was the only determinant of successful salt restriction (P<0.01). In conclusion, compliance with salt restriction, assessed using a spot urine method, was maintained over the long term; however, achieving salt reduction to the level recommended by the guidelines remains a challenge.
authors.affiliation: Division of Cardiology, Ueki Hospital, Kumamoto, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Hirota
authors.forename: Tsuneaki
authors.initials: T
authors.lastname: Sadanaga
authors.forename: Hideo
authors.initials: H
authors.lastname: Mitamura
authors.forename: Keiichi
authors.initials: K
authors.lastname: Fukuda
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001835:Body Weight; D004039:Diet, Sodium-Restricted / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000178:diet therapy* / Q000453:epidemiology / Q000652:urine; D006801:Humans; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012737:Sex Factors; D012964:Sodium / Q000652:urine*
chemical_list: D012964:Sodium